MMR Vaccine Research Articles

Attitudes toward Rubella and Varicella Vaccination during Preconception Care

Introduction. MMR and Varicella vaccines contain live attenuated virus, a contraindication during pregnancy. For this reason, it is important to clinically assess barriers to vaccination during the preconception time period to avoid the known fetal morbidity associated with congenital Rubella or Varicella infection. Methods. To determine the prevalence of patients with nonimmune status for Rubella and Varicella in the setting of advanced reproductive care. Secondary outcomes of interest included further understanding nonimmune reproductive-aged women's attitudes toward MMR and Varicella vaccination during the preconception time frame. Patient records were with lab orders for Rubella or Varicella immunoglobulin titers, placed at the KU Advanced Reproductive Care clinic between January 2017 and June 2020. A cross-sectional survey was administered to patients with a laboratory reported negative titer result. Results. Prevalence of nonimmunity within the study population to either Rubella and/or Varicella was 10.7% (n=1,979), to Rubella, 6.0% (n=134) and to Varicella, 3.8% (n=85) out of a total 2,217 patient records reviewed. The women who did not receive recommended vaccines following a nonimmune titer result (n=19) most commonly cited their rationale was to not further delay fertility treatment (n=8). Conclusions. The prevalence of nonimmune persons in the study population fell within the range recognized to be sufficient for herd immunity. The risk/benefit analysis of postponing fertility treatment to achieve adequate levels of immunity should be a focused discussion when establishing fertility treatment goals with patients in the setting of advanced reproductive care.

A randomized trial assessing the efficacy, immunogenicity, and safety of vaccination with live attenuated varicella zoster virus-containing vaccines: ten-year follow-up in Russian children

ABSTRACT In Russia, a universal varicella vaccination (UVV) program has not been implemented, and varicella vaccination coverage is low. We assessed the efficacy, antibody persistence, and safety of one- and two-dose varicella vaccination schedules in Russian children with a ten-year follow-up period, as part of an international phase IIIB, observer-blind, randomized, controlled trial (NCT00226499). Children aged 12–22 months were randomized (3:3:1) to receive two doses of tetravalent measles-mumps-rubella-varicella vaccine (V2 group), one dose trivalent measles-mumps-rubella (MMR) vaccine and one dose of varicella vaccine (V1 group), or two doses of MMR vaccine (V0 [control] group), 42 days apart. Main study outcomes were: vaccine efficacy (VE) against confirmed varicella cases, anti-varicella zoster virus (VZV) seropositivity rates and geometric mean concentrations, and reporting of (serious) adverse events ([S]AEs). The total vaccinated cohort in Russia comprised 1000 children; 900 were followed up until study end (year [Y] 10). VE estimates against confirmed varicella (Y10) were 92.4% in the V2 group and 74.7% in the V1 group. Anti-VZV seropositivity rates remained ≥99.4% in the V2 group and ≥89.7% in the V1 group from day 42 post-vaccination 2 until Y10. Occurrence of (un)solicited AEs and SAEs was similar across groups and confirmed the safety profile of the vaccines. No vaccination-related SAEs or deaths were reported. These results are consistent with the global trial results, i.e., the highest VE estimates observed following the two-dose schedule compared to the one-dose schedule. These data may inform decision-making related to potential implementation of a UVV program.

Quantifying the effect of Wakefield et al. (1998) on skepticism about MMR vaccine safety in the U.S.

Efforts to trace the rise of childhood vaccine safety concerns in the US often suggest Andrew Wakefield and colleagues' retracted 1998 Lancet study (AW98)-which alleged that the MMR vaccine can cause children to develop autism-as a primary cause of US vaccine skepticism. However, a lack of public opinion data on MMR safety collected before/after AW98's publication obscures whether anecdotal accounts are indicative of a potentially-causal effect. We address this problem using a regression discontinuity framework to study change in monthly MMR injury claims (N = 74,850; from 1990-2019) from the Vaccine Adverse Events Reporting System (VAERS) to proxy concern about vaccine safety. Additionally, we suggest a potential mechanism for the effect of AW98 on vaccine skepticism, via automated sentiment analyses of MMR-related news stories (N = 674; from 1996-2000) in major television and newspaper outlets. AW98 led to an immediate increase of about 70 MMR injury claims cases per month, averaging across six estimation strategies (meta-analytic effect = 70.44 [52.19, 88.75], p < 0.01). Preliminary evidence suggests that the volume of negative media attention to MMR increased in the weeks following AW98's publication, across four estimation strategies (meta-analytic effect = 9.59% [3.66, 15.51], p < 0.01). Vaccine skepticism increased following the publication of AW98, which was potentially made possible by increased negative media coverage of MMR. Childhood vaccine skepticism presents an important challenge to widespread vaccine uptake, and undermines support for pro-vaccine health policies. In addition to advancing our understanding of the previously-obscured origins of US vaccine skepticism, our work cautions that high-profile media attention to inaccurate scientific studies can undermine public confidence in vaccines. We conclude by offering several recommendations that researchers and health communicators might consider to detect and address future threats to vaccine confidence.

Protective heterologous T cell immunity in COVID-19 induced by the trivalent MMR and Tdap vaccine antigens

BackgroundT cells control viral infection, promote vaccine durability, and in coronavirus disease 2019 (COVID-19) associate with mild disease. We investigated whether prior measles-mumps-rubella (MMR) or tetanus-diphtheria-pertussis (Tdap) vaccination elicits cross-reactive T cells that mitigate COVID-19.MethodsAntigen-presenting cells (APC) loaded ex vivo with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MMR, or Tdap antigens and autologous T cells from COVID-19-convalescent participants, uninfected individuals, and COVID-19 mRNA-vaccinated donors were co-cultured. T cell activation and phenotype were detected by interferon-γ (IFN-γ) enzyme-linked immunospot (ELISpot) assays and flow cytometry. ELISAs (enzyme-linked immunosorbant assays) and validation studies identified the APC-derived cytokine(s) driving T cell activation. TCR clonotyping and single-cell RNA sequencing (scRNA-seq) identified cross-reactive T cells and their transcriptional profile. A propensity-weighted analysis of COVID-19 patients estimated the effects of MMR and Tdap vaccination on COVID-19 outcomes.FindingsHigh correlation was observed between T cell responses to SARS-CoV-2 (spike-S1 and nucleocapsid) and MMR and Tdap proteins in COVID-19-convalescent and -vaccinated individuals. The overlapping T cell population contained an effector memory T cell subset (effector memory re-expressing CD45RA on T cells [TEMRA]) implicated in protective, anti-viral immunity, and their detection required APC-derived IL-15, known to sensitize T cells to activation. Cross-reactive TCR repertoires detected in antigen-experienced T cells recognizing SARS-CoV-2, MMR, and Tdap epitopes had TEMRA features. Indices of disease severity were reduced in MMR- or Tdap-vaccinated individuals by 32%–38% and 20%–23%, respectively, among COVID-19 patients.ConclusionsTdap and MMR memory T cells reactivated by SARS-CoV-2 may provide protection against severe COVID-19.FundingThis study was supported by a National Institutes of Health (R01HL065095, R01AI152522, R01NS097719) donation from Barbara and Amos Hostetter and the Chleck Foundation.

UniCoVac Position Paper: Considerations for University Campus-Based Programmes for COVID-19 and Other Infectious Disease Vaccines

This position paper sets out the rationale, logistics and limitations for delivery of COVID-19, MMR and meningitis vaccines to university students. Key aspects considered are ascertainment of vaccine status and campus-based delivery of vaccines. The approaches described in this position paper require an inter-disciplinary approach. There will be a requirement for data analysts to enable personalised, secure access to vaccination records, for social media experts and sociologists to design appropriate pathways and literature for disseminating information and for public health experts to oversee literature outputs and delivery of campus-based immunisation programmes. Contributions from vaccinologists, economists and modellers will also be required for monitoring and assessing the utility of implemented recommendations.

Case report: aseptic meningitis secondary to varicella-zoster virus (VZV) without an exanthem post MMR vaccination

BackgroundVaricella-zoster virus (VZV) is a known cause of aseptic meningitis, with a predisposition for an immunocompromised population. A dermatomal rash usually accompanies aseptic meningitis secondary to VZV.Case presentationWe report the case of a 31-year-old male with a history of chickenpox in childhood and recent shingles who presented with severe frontal headaches secondary to VZV meningitis. The patient had also recently received the measles-mumps-rubella (MMR) vaccine. He recovered without any neurological sequala.ConclusionThis case report describes an immunocompetent patient with recent MMR vaccination who developed aseptic meningitis secondary to VZV without any dermatomal involvement (Zoster Sine Herpete).

COVID-19 Vaccine Associated Parkinson's Disease, A Prion Disease Signal in the UK Yellow Card Adverse Event Database

Many have argued that SARS-CoV-2 spike protein and its mRNA sequence, found in all COVID-19 vaccines, are priongenic. The UK’s Yellow Card database of COVID-19 vaccine adverse event reports was evaluated for signals consistent with a pending epidemic of COVID vaccine induced prion disease. Adverse event reaction rates from AstraZeneca’s vaccine were compared to adverse event rates for Pfizer’s COVID vaccines. The vaccines employ different technologies allowing for potential differences in adverse event rates but allowing each to serve as a control group for the other. The analysis showed a highly statistically significant and clinically relevant (2.6-fold) increase in Parkinson’s disease, a prion disease, in the AstraZeneca adverse reaction reports compared to the Pfizer vaccine adverse reaction reports (p= 0.000024). These results are consistent with monkey toxicity studies showing infection with SARS-CoV-2 results in Lewy Body formation. The findings suggest that regulatory approval, even under an emergency use authorization, for COVID vaccines was premature and that widespread use should be halted until full long term safety studies evaluating prion toxicity has een complete. Alternative vaccines like the Measles Mumps Rubella (MMR) vaccine should be explored for those desiring immunization against COVID-19.Many have argued that SARS-CoV-2 spike protein and its mRNA sequence, found in all COVID-19 vaccines, are priongenic. The UK’s Yellow Card database of COVID-19 vaccine adverse event reports was evaluated for signals consistent with a pending epidemic of COVID vaccine induced prion disease. Adverse event reaction rates from AstraZeneca’s vaccine were compared to adverse event rates for Pfizer’s COVID vaccines. The vaccines employ different technologies allowing for potential differences in adverse event rates but allowing each to serve as a control group for the other. The analysis showed a highly statistically significant and clinically relevant (2.6-fold) increase in Parkinson’s disease, a prion disease, in the AstraZeneca adverse reaction reports compared to the Pfizer vaccine adverse reaction reports (p= 0.000024). These results are consistent with monkey toxicity studies showing infection with SARS-CoV-2 results in Lewy Body formation. The findings suggest that regulatory approval, even under an emergency use authorization, for COVID vaccines was premature and that widespread use should be halted until full long term safety studies evaluating prion toxicity has been complete. Alternative vaccines like the Measles Mumps Rubella (MMR) vaccine should be explored for those desiring immunization against COVID-19.

Incidence of Vaccine-Preventable Childhood Diseases in the European Union and in the European Free Trade Association Countries.

Introduction: Despite the widespread availability of vaccines, the incidence of vaccine-preventable childhood diseases (VPCD) started to grow in recent years. The aim of the study was to compare the annual incidence of selected VPCDs in the EU (European Union) and EFTA (European Free Trade Association) countries in the period of the last 5 years (2014–2019 or other intervals, depending on data availability), and the country-specific vaccine schedules. Methods: VPCD incidence rates in Europe were based on “The Surveillance Atlas of Infectious Diseases” by the ECDC (European Centre for Disease Prevention and Control); vaccination schedules were based on ECDC reports. Results: The obligation to vaccinate was not universal, and it generally only applied to two preparations: the MMR (measles, mumps, rubella) vaccine and the one against polio. During the study, the situation associated with mumps did not change or improve in individual countries; the median incidence amounted to 30 cases. The median incidence associated with rubella amounted to 1 case, but in a few countries, it grew very rapidly, i.e., in Germany, Italy, and Romania; in Poland, the incidence was clearly decreasing, from 5923 to 1532 cases. The most dynamic situation concerned measles. The total median was 2.4 cases per 100,000 population; the only one country with falling incidence was Germany. The diseases associated with Streptococcus pneumoniae and Neisseria meningitidis remained at a stable level in all analyzed countries. Conclusion: Vaccine schedules differ among the countries, so does the epidemiological situation of selected diseases. Morbidity on measles was the most disturbing phenomenon: the incidence rate increased in almost 40% of all countries, regardless of the obligation to vaccinate. The increasing incidence of VPCD may be due to anti-vaccine movements, the activity of which is often caused by mistrust and spreading misinformation. In order to better prevent the increase in morbidity, standardization of vaccine schedules and documentation should be considered in the EU countries.

Immunogenicity and safety of concomitant inoculation of Measles and rubella combined live vaccine and Japanese encephalitis attenuated live vaccine

Objective: To evaluate the immunogenicity and safety of concomitant inoculation of Measles and Rubella Combined Live-attenuated Japanese encephalitis vaccine. Methods: Healthy children aged 8 months in selected cities in Zhejiang Province were randomly assigned to the MR and JVE-L combined vaccination group (the experimental group), and the MR single vaccination group (the control group) was taken before the exemption and 6 weeks after the exemption. Peripheral venous blood 1 ml was used as serum antibody test for measles and rubella, and the levels of measles and rubella antibodies before and after vaccination were evaluated. The safety of combined vaccination was evaluated. Measles and rubella IgG antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Data were double-entry with Epidata and statistical analysis was performed using Epi Info epidemiological statistical analysis software. Results: The results showed that no severe adverse event occurred in two groups, clinical reactions in each inoculation group were mild.The seroconversion rate of measles antibody and rubella antibody were 96.43% and 88.49% in the experimental group after vaccination, the geometrical mean concentrations(GMC) of measles antibody was 1 526.45 mIU/ml and the GMC of rubella antibody was 47.70 mIU/ml after concomitant inoculation; the seroconversion rate of measles antibody and rubella antibody were 97.62% and 86.11% in the control group, the GMC of Measles antibody was 1 392.28 mIU/ml and the GMC of Rubella antibody was 45.72 mIU/ml after MV inoculation. No difference were detected in two groups of seroconversion rate of measles antibody and rubella antibody and GMC after vaccination. Conclusion: The immunogenicity and safety is equivalent when MR and JVE-L were simultaneous inoculation.

The vaccine coverage and vaccine immunity status and risk factors of non-protective levels of antibodies against vaccines in children with juvenile idiopathic arthritis: cross-sectional Russian tertiary Centre study

BackgroundImmunosuppressive drugs, incomplete vaccine coverage, immune system dysregulation might be factors of a low level of anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity, and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B, and diphtheria in JIA patients.MethodsA cross-sectional study included 170 children diagnosed with JIA aged 2 to 17 years who received routine vaccinations against measles, rubella, mumps (MMR), diphtheria, and hepatitis B national vaccine schedule. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B, and diphtheria were measured with ELISA.ResultsProtective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. MMR’s best coverage had patients with enthesitis-related arthritis-85%, compared to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50, 51, 46, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p = 0.025), and 61, 46, 36% for diphtheria (p = 0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR = 2.03 [95%CI: 1.02; 4.0], p = 0.042), mumps (HR = 6.25 [95%CI: 2.13; 17.9], p = 0.0008) and diphtheria (HR = 2.39 [95%CI: 1.18; 4.85], p = 0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines. One-third part of JIA patients continued vaccination against MMR and diphtheria without serious adverse events and JIA flare. There were no differences between patients who continued MMR vaccination or denied in the means of JIA category and treatment options. Patients, continued diphtheria vaccination rare received methotrexate (p = 0.02), biologics (p = 0.004), but had higher levels of anti-diphtheria antibodies (p = 0.024) compare who omitted vaccination. Methotrexate (OR = 9.5 [95%CI: 1.004; 90.3]) and biologics (OR = 4.4 [95%CI: 1.6; 12.1]) were predictors of omitted diphtheria revaccination.ConclusionChildren with JIA may have lower anti-vaccine antibody levels and required routine checks, especially in children with incomplete vaccination, biologics, systemic arthritis, and long-term methotrexate treatment. Revaccination of JIA patients was safe and effective.

Compliance With Vaccination Recommendations Among Patients With Multiple Myeloma: A Real World Experience.

Compliance With Vaccination Recommendations Among Patients With Multiple Myeloma: A Real World Experience.

Vaccine hesitancy in Argentina: Validation of WHO scale for parents

BackgroundThe WHO SAGE Working Group on Vaccine Hesitancy developed the Vaccine Hesitancy Scale (VHS) to identify and compare hesitancy in different global settings. The objectives of the study were to describe and analyze vaccine hesitancy and to validate the VHS in a group of parents in Buenos Aires city, Argentina. MethodsA cross-sectional survey was conducted in parents of 1–3 and 12–15 year-old children at three health centres in Buenos Aires City, between June 2018 and May 2019. Sociodemographic data were collected together with history of refusal and/or delay in children’s vaccination (defined as hesitancy). The 10-item VHS using 5-point Likert-scale (higher scores indicating lower hesitancy) was administered and children’s immunization record cards were verified. Link between hesitancy and socio-demographic variables, and hesitancy and vaccination status was analyzed for five specific vaccines. Cronbach‘s α was used to determine internal consistency reliability and factor analysis to confirm survey subdomains. Simple and multiple regression analysis was used to examine associations between VHS scores and hesitancy, and VHS scores and vaccination status. ResultsSix hundred parents were surveyed and 469 immunization cards verified; 11.5% (n = 69) parents were hesitant. High maternal educational level showed significant association with hesitancy (OR 2.66 95% CI: 1.20–5.9) in the adjusted model. Hesitancy was significantly associated with incomplete MMR vaccination in children (OR 4.43 95% CI: 1.08–8.20) and HPV vaccination in adolescents (OR 3.75 95% CI: 1.54–9.12). Cronbach‘s α was 0.66 and factor analysis identified three underlying constructs: “Benefits”, “Harms” and “Confidence in healthcare system”. High scores in VHS were associated with lack of hesitancy (OR 1.2 95% CI: 1.13–1.27) and complete vaccination status (OR 1.07 95% CI: 1.02–1.12). ConclusionsHesitancy was associated with high maternal educational level, and incomplete MMR and HPV immunization status in children and adolescents. VHS was a reliable and valid tool in this population.

Comparison of Vaccination Associated and Non-Vaccination Associated Paediatric Immune Thrombocytopenia

Primary ITP is a rare disease defined as thrombocytopenia in the absence of an underlying condition. Characteristic signs include easy bruising, petechial rash and epistaxis. Whilst in many cases the aetiology is unknown, there is a known link with childhood vaccinations.Objectives: To compare the key features of vaccine associated ITP with non-vaccine associated ITP. Addressing the hypotheses that the severity of bleeding is milder, the clinical course shorter and the requirement for treatment less in vaccine associated ITP.Methods: Data on 1469 patients was extracted from the UK paediatric registry www.uk-itp.org . The vaccination group included those vaccinated in the 6 weeks prior to the onset of ITP. Their data including; demographics, vaccine type, platelet counts and treatments was then analysed using appropriate statistical methods.Results: 37 patients had vaccine associated ITP, 51% of which following the MMR vaccine. The median time from vaccination to onset of symptoms was 15 days. 97% of the vaccination group presented with mild or moderate bleeding symptoms compared to 95% of the non-vaccine group. The time for the platelet count to recover was statistically different (P=0.008), being much quicker in the vaccination associated group (median 19 days compared to 99 days in the non-vaccine group). 19% of the vaccine cohort required treatment with either steroids or IVIG which was less than in the non-vaccine group where 21% received treatment (P=0.053).Conclusion: The data supports the hypothesis that vaccine associated ITP resolves more quickly and requires less treatment than non-vaccination associated ITP. [Display omitted] DisclosuresGrainger:GSK: Honoraria; Amgen Inc.: Honoraria; Novartis: Honoraria.

Measles like syndrome after measles and rubella vaccination

National vaccination program (NIS, IAP) provides vaccination for measles and rubella (MR vaccine) for all children below 15 years of age. After vaccination with live attenuated viruses, the virus replicates on a limited scale. Replication may lead to mild symptoms occurring 5-14 days after MR-vaccination including fever, conjunctivitis and rash but sometimes it leads to florid type of severe rashes which are indistinguishable from a wildtype measles infection. A measles like syndrome may occur following MR vaccination, although it seems to be a rare event and therefore as a pediatrician we must take out time to educate and reassurance the parents about this benign nature and so as to avoid unnecessary problems in future. A 14 year old female child was admitted in our hospital with an impressive (florid) rashes, 7 days after MR vaccination in our vaccination clinic. Diagnostic tests were negative for measles and other infections and was discharged after 7 days of nursing and supportive care. Within 14 days after MR vaccination, a child can present with symptoms very similar to a wildtype measles virus infection. The low incidence of wildtype measles infection after MR vaccination, strongly suggests that these symptoms will likely be a reaction to MR vaccination. To elaborate lots of diagnostic procedures may cause the parents a lot of stress and therefore offering nursing care, supportive care and reassurance to parents may be more appropriate and effective in such cases.

Vaccination deaths and the samoan measles outbreak

On July 6th 2018, two 1 year old infants died shortly after receiving the Measles Mumps Rubella (MMR) vaccine. Events over the following months amplified this tragedy. The investigation of these deaths will discussed, along with the events that culminated in an epidemic that resulted in the death of 83 people, predominantly children, in the Pacific nation.

Recent MMR vaccination in health care workers and Covid-19: A test negative case-control study

BackgroundIt has been hypothesised that the measles-mumps-rubella (MMR) vaccine may afford cross-protection against SARS-CoV-2 which may contribute to the wide variability in disease severity of Covid-19. MethodsWe employed a test negative case-control study, utilising a recent measles outbreak during which many healthcare workers received the MMR vaccine, to investigate the potential protective effect of MMR against SARS-CoV-2 in 5905 subjects (n = 805 males, n = 5100 females). ResultsThe odds ratio for testing positive for SARS-CoV-2, in recently MMR-vaccinated compared to not recently MMR-vaccinated individuals was 0.91 (95% CI 0.76, 1.09). An interaction analysis showed a significant interaction for sex. After sex-stratification, the odds ratio for testing positive for males was 0.43 (95% CI 0.24, 0.79, P = 0.006), and 1.01 (95% CI 0.83, 1.22, P = 0.92) for females. ConclusionOur results indicate that there may be a protective effect of the MMR vaccine against SARS-CoV-2 in males but not females.

Differential Demographic and Clinical Characteristics between MMR Vaccinated and Unvaccinated Children in South Korea: A Nationwide Study.

In the context of recent measles outbreaks, substantial factors associated with measles-mumps-rubella (MMR) unvaccination need to be clarified. This study aimed to identify differential demographic and clinical characteristics between MMR vaccinated and unvaccinated groups. We used a large-linked database to identify children born between 2008 and 2016 by combining data from the Korea Immunization Registry Information System and National Health Information database. The MMR vaccination status was ascertained up to the age of 2 to define MMR vaccinated and unvaccinated groups. We conducted a multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) to identify factors associated with MMR unvaccination. Of 3,973,253 children, 75,674 (1.9%) did not receive the MMR vaccine. Compared with the MMR vaccinated group, the underutilization of healthcare resources was more notable in the MMR unvaccinated group (number of outpatient visits (5.73 ± 12.1 vs. 25.8 ± 17.06); days hospitalized (1.69 ± 14.5 vs. 2.32 ± 6.90)). Children were less likely to receive the MMR vaccine if they were born with congenital anomaly (OR 2.12; 95% CI 1.90–2.36), were never admitted to an intensive care unit (1.88; 1.78–1.98), or never visited an emergency room (3.57; 3.53–3.72). There were substantial factors associated with MMR unvaccination, underscoring a need to optimize targeted interventions tailored to the subset of children in South Korea.

Immunogenicity and safety of a boost dose of measles, mumps, and rubella combined vaccine for 4-6 years old children

Objective: To investigate the immunogenicity and safety of a boost dose of measles, mumps, and rubella combined vaccine (MMR) for children 4 to 6 years old. Methods: Children, aged 4 to 6 years old, had vaccinated with 1 dose of measles and rubella combined vaccine(MR) at the age of 8 months and 1 dose of MMR vaccine at 18-months, were recruited in Shanxi, Inner Mongolia, and Beijing, respectively. All children were assigned into 4, 5 and 6-year-old group. The children who met inclusion and exclusion criteria were vaccinated with 1 dose MMR vaccine, and were collected blood samples before vaccination and 35 to 42 d after the vaccination. During the study period, adverse events were collected at 30 min, 1 d, 2 d, 3 d, 4-12 d, and 13 to 42 days after vaccination. Serum was tested for IgG antibodies against measles, mumps and rubella. Geometric mean concentrations (GMC) of measles, mumps, and rubella antibodies were compared among groups by analysis of variance or non-parametric test. Seropositive rates and adverse event rates were compared among groups by Chi-square test or Fisher exact test. Results: A total of 500 children were included in immunogenicity analysis and 535 children were included in safety analysis. The overall adverse event rate was 20.37%, the most of severity for adverse events was mild. The rates of local and systemic adverse events were 0.37% and 20.00%, respectively. Symptoms of local adverse events were redness. The main systemic adverse events were fever, followed by cough, rash and runny nose. Received a dose of MMR vaccine for booster immunization, the seropositive rates of measles antibody, mumps antibody and rubella antibody were above 99% for all 3 age groups, and there was no significant difference between groups. There were significant differences in mumps antibody GMC among groups (P=0.042), but no significant differences in measles and rubella antibodies GMC. Conclusion: The immunogenicity and safety of a boosted MMR vaccintion in children aged 4, 5 and 6 years were all similar good.

Seroprevalence of Measles-, Mumps-, and Rubella-specific antibodies in the German adult population - cross-sectional analysis of the German Health Interview and Examination Survey for Adults (DEGS1).

BackgroundThe WHO European Region targets the elimination of measles, rubella, and the congenital rubella syndrome and welcomes mumps elimination via the joint MMR vaccine. In a push towards this elimination goal, Germany introduced a recommendation on MMR vaccination for adults in 2010 to prevent increasing numbers of measles cases among adults and to strengthen herd immunity.MethodsThe prevalence of anti-measles, -mumps, and -rubella IgG antibodies was analysed in 7,115 participants between the ages of 18 and 79 years in the German Health Interview and Examination Survey. Risk factors of seronegativity of adults born 1970 or later were determined.FindingsThe seroprevalence of anti-measles IgG antibodies was more than 97% in adults born before 1965 and less than 90% in adults born afterwards. Prevalence and GMTs declined with later years of birth. Seronegativity was associated with two-sided migration background and region of residence in East Germany. For anti-mumps IgG antibodies, the seroprevalence was less than 90% in almost all age groups. Prevalence and GMTs declined with later years of birth. Seronegativity was not associated with any socio-demographic factor. Anti-rubella IgG seropositivity was found in more than 90% of adults born before 1985. GMTs declined in younger age groups. Seronegativity was associated with birth between 1980 and 1993 and male gender. High socio-economic status lowered the odds of being seronegative.InterpretationThese data reinforce the implementation of the vaccination recommendation for adults and provide the basis for further evaluation of this measure.FundingThe Federal Ministry of Health, Germany.

Review of the measles epidemic in children from Central Eastern Europe in the third millennium.

Measles is an extremely contagious viral disease. Even though a safe vaccine exists for this disease, it remains one of the leading causes of mortality and morbidity in infants and young children. We aimed to create a retrospective descriptive study in which to analyze the evolution of the measles epidemic at the European level. The documentation was carried out using European Centre for Disease Prevention and Control (ECDC) and World Health Organization (WHO) statistics. At the same time, we present the epidemic's evolution in Romania, using data provided by the Romanian National Institute of Public Health and Ministry of Health. European statistical data indicate a high number of patients diagnosed with measles both among children and adults. All European countries benefit from the measles vaccination in the form of the measles-mumps-rubella (MMR) trivaccine included in their National Vaccination Programme. The vaccination schedule varies from country to country. In the vaccination scheme, most European countries include two doses of the MMR vaccine among the pediatric population. Romania registered a limited number of cases of measles between 1980 and 2015 following the introduction of the measles vaccination in the National Vaccination Programme. Since 2005, the Romanian vaccination schedule includes two doses of MMR trivaccine, administered at 12 months and at 6-7 years. After 2015, as a result of a significant decrease in the number of vaccinated children, Romania is facing a major increase in the cases of measles. Consecutively, a measles epidemic was declared in 2016 and an additional dose of mandatory MMR trivaccine was introduced at the age of 9 months. After 4 years of this schedule of administration, starting with August 2020, the additional dose of MMR administered during infancy has been discontinued. We propose an analysis of the factors that influenced the downward evolution of the measles epidemic in Romania at the beginning of the third millennium. Issues related to the limitation of interpersonal contact in the context of the social distancing imposed by the Sars-CoV-2 virus pandemic are discussed. We consider necessary a detailed documentation of the percentage of new disease cases that will appear in the pediatric population in the near future, in the context of the resumption of daily activity after the reopening of nurseries, kindergartens and schools.